Toward more accurate prediction of future pregnancy outcome in couples with unexplained recurrent pregnancy loss: taking both partners into account

Abstract

Objective: To identify, besides maternal age and the number of previous pregnancy losses, additional characteristics of couples with unexplained recurrent pregnancy loss (RPL) that improve the prediction of an ongoing pregnancy. Design: Hospital-based cohort study in couples who visited specialized RPL units of two academic centers between 2012 and 2020. Setting: Two academic centers in the Netherlands. Patients: Clinical data from 526 couples with unexplained RPL were used in this study. Intervention(s): None. Main Outcome Measures: The final model to estimate the chance of a subsequent ongoing pregnancy was determined using a backward selection process and internally validated using bootstrapping. Model performance was assessed in terms of calibration and discrimination (area under the receiver operating characteristic curve). Results: Subsequent ongoing pregnancy was achieved in 345 of 526 couples (66%). The number of previous pregnancy losses, maternal age, paternal age, maternal body mass index, paternal body mass index, maternal smoking status, and previous in vitro fertilization/intracytoplasmic sperm injection treatment were predictive of the outcome. The optimism-corrected area under the receiver operating characteristic curve was 0.63 compared with 0.57 when using only the number of previous pregnancy losses and maternal age. Conclusions: The identification of additional predictors of a subsequent ongoing pregnancy after RPL, including male characteristics, is significant for both clinicians and couples with RPL. At the same time, we showed that the predictive ability of the current model is still limited and more research is warranted to develop a model that can be used in clinical practice.

Association Study between Mucin 4 (MUC4) Polymorphisms and Idiopathic Recurrent Pregnancy Loss in a Korean Population

“…Etiological factors of RPL include advanced maternal age, immunological problems, endocrine dysfunction, and anomalies of maternal anatomy, chromosomes, and placenta [ 5 , 6 , 7 ]. Moreover, environmental factors such as infection, smoking, alcohol, psychological trauma, and stress may contribute to RPL [ 8 , 9 , 10 ]. However, the cause of RPL is unclear in 30–40% of cases, and recent studies suggest that genetic factors play an important role in the pathogenesis of idiopathic RPL [ 11 , 12 ].…”

Male fertility: summary overview of the publications January – March 2022

“…имевшиеся ранее способы прогнозирования успешной беременности несовершенны и опираются исключительно на информацию относительно матери. поэтому авторы данной работы предприняли попытку разработать инструмент для прогнозирования невынашивания беременности, опираясь на показатели, как со стороны матери, так и со стороны отца [9].…”

Development of the OPAL prediction model for prediction of live birth in couples with recurrent pregnancy loss: protocol for a prospective and retrospective cohort study in the Netherlands

“…None of them incorporated different causes for RPL, nor did they include paternal factors to establish a prediction specific to individual couples. 17 Furthermore, obstetric complications after RPL are not part of these models. 18 19 Individual couples with RPL now have an unclear prognosis of future success in terms of having a live birth.…”

“…In addition, all earlier prediction models focused on the unexplained RPL population and on maternal predictors. None of them incorporated different causes for RPL, nor did they include paternal factors to establish a prediction specific to individual couples 17. Furthermore, obstetric complications after RPL are not part of these models 18 19…”